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Preparing for Z-Codes as DEX Genetic Testing Registry Rolls Out to Commercial Health Plans
Palmetto GBA’s Chief Medical Officer will cover how clinical laboratories billing for genetic testing should prepare for Z-Codes at the upcoming Executive War College in New Orleans After multiple delays, UnitedHealthcare (UHC) commercial plans will soon require clinical laboratories to use Z-Codes when submitting claims for certain molecular diagnostic tests. Several private insurers, including UHC, […] The post Preparing for Z-Codes as DEX Genetic Testing Registry Rolls Out to Commercial Health Plans appeared first on Dark Daily. (Source: Dark Daily)
Source: Dark Daily - April 22, 2024 Category: Laboratory Medicine Authors: Jillia Schlingman Tags: Coding, Billing, and Collections Laboratory News Laboratory Resources Pathology and Clinical Laboratory Conferences analytes anatomic pathology centers for medicare and medicaid services Change Healthcare clinical pathology CMS cpt cod Source Type: news

What's brewing in RT and RA legislation, policy, and standards?
A range of federal and state legislation and other developments in the works could have a significant impact on radiologic technologists and registered radiology assistants, either supporting and strengthening these professions or weakening them. For example, the American Society of Radiologic Technologists (ASRT) is working with lawmakers to reintroduce the federal Medicare Access to Radiology Care Act (MARCA) in the current legislative session. Last introduced in June 2021 as HR-3657 and companion SB-2641, MARCA would amend Medicare reimbursement policy for radiologist assistants (RAs) to align reimbursement with st...
Source: AuntMinnie.com Headlines - April 22, 2024 Category: Radiology Authors: Liz Carey Tags: Industry News Radiologic Technologist Source Type: news

Some Older Women Need Extra Breast Scans. Why Won ’t Medicare Pay?
Mammography can miss tumors in women with dense breasts, so their doctors often include ultrasound or M.R.I. scans. Patients often wind up paying the bill. (Source: NYT Health)
Source: NYT Health - April 19, 2024 Category: Consumer Health News Authors: Roni Caryn Rabin Tags: your-feed-science Breast Cancer Tests (Medical) Mammography Women and Girls Medicare Disease Rates Ultrasonic Imaging and Sonograms Tumors Preventive Medicine Centers for Medicare and Medicaid Services Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comments on the following information collections: 1) Transitional Coverage and Retroactive Medicare Part D Coverage for Certain Low-Income Beneficiaries through the Limited Income Newly Eligible Transition (LI NET) Program; and 2) Appointment of Representative and Supporting Regulations in 42 CFR 405.910, which says that an individual or entity may appoint a representative to act of their behalf when exercising their rights for claim determinations and appeals. Comments are due June 11, 2024. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 12, 2024 Category: Rural Health Source Type: news

Why big Medicare Advantage insurers may root for Biden to lose in 2024
Insurance giants have a bigger stake in this year’s presidential election after recent moves by the Biden administration cut into the profitability of Medicare Advantage plans. In the last week, the Centers for Medicare and Medicaid Services (CMS) delivered consecutive blows to the industry that…#medicareadvantage #centersformedicare #medicaidservices #cms #medicare #leerinkpartners #yahoofinance #mayo #humana #unitedhealthcareunh (Source: Reuters: Health)
Source: Reuters: Health - April 12, 2024 Category: Consumer Health News Source Type: news

SNMMI to tackle Capitol Hill
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) will host its annual Hill Day on 5 in Washington, DC, with 65 members, patients, and industry colleagues set to lobby on key issues in the field. On the agenda are discussions concerning the Nuclear Medicine Clarification Act of 2023 (H.R. 6815), which was introduced in the House on January 5. The legislation would direct the Nuclear Regulatory Commission (NRC) to revise its regulations on event reporting “to protect patients from unintended exposure to radiation during nuclear medicine procedures,” the SNMMI said in a recent announcement. “The SNMMI i...
Source: AuntMinnie.com Headlines - April 3, 2024 Category: Radiology Authors: AuntMinnie.com staff writers Tags: Industry News Nuclear Medicine Source Type: news

HPI study shows radiologists at MIPS disadvantage
Impeded by a smaller number of radiology-applicable quality measures, in 2021 radiologists in radiology-only practices scored significantly lower on relevant Merit-based Incentive Payment System (MIPS) gauges compared with other specialties.In contrast, those in multispecialty practices scored higher in the U.S. Centers for Medicare and Medicaid Services (CMS) MIPS, although they rarely reported radiology-relevant MIPS quality measures, instead tracking those relevant to other specialties, according to a research letter from the Harvey L. Neiman Health Policy Institute (HPI) published April 3 in the American J...
Source: AuntMinnie.com Headlines - April 3, 2024 Category: Radiology Authors: Kate Madden Yee Tags: Practice Management Source Type: news

UnitedHealth, Health Insurers Tumble On Medicare Advantage Rates
tumbled late Monday while other health insurers such as CVS Health (CVS) and Cigna (CI) ended mixed after the Biden Administration announced that final Medicare Advantage rates in 2025 won't change from initial plans in January. The Centers for Medicare and Medicaid Services announced late Monday…#humana #hum #cvshealth #cvs #cigna #medicareadvantage #centersformedicare #medicaidservices #cms #unitedhealth (Source: Reuters: Health)
Source: Reuters: Health - April 1, 2024 Category: Consumer Health News Source Type: news

Your Medicare coverage is hugely influenced by something called ‘the two-midnight rule.’ Here’s what that is
When a clinician admits a Medicare beneficiary for inpatient care, their choice may have been influenced by a Centers for Medicare and Medicaid Services (CMS) standard that sounds like a term from a spy novel: the two-midnight rule. The two-midnight rule is used when a clinician believes that a…#medicare #centersformedicare #medicaidservices #cms #regantankersley #hallrender #healthcarebrew #tankersley #recoveryaudit #hhsoig (Source: Reuters: Health)
Source: Reuters: Health - March 30, 2024 Category: Consumer Health News Source Type: news

Medicare can now cover certain weight loss drugs in a big step for patients
Boxes of Wegovy made by Novo Nordisk are seen at a pharmacy in London, Britain March 8, 2024. Medicare can start covering certain weight loss drugs for the first time — as long as they are approved for an added health benefit, the Centers for Medicare and Medicaid Services said Thursday. That…#boxesofwegovy #novonordisk #medicare #centersformedicare #medicaidservices #cms #elililly #fda #glp1s #cvshealth (Source: Reuters: Health)
Source: Reuters: Health - March 21, 2024 Category: Consumer Health News Source Type: news

Don ’ t Be Surprised If Your Doctor Starts Charging You for Email
Doctors are starting to charge for responding to email, and other offline tasks. Is it justified or just extra costs in an endless stream of medical bills? It’s 6 pm and you might expect your doctor’s workday to be complete after a busy patient load. Yet for majority, work has just begun. It’s time to open their patient portal, review test results, answer piles of patient email. Then they do whatever needs to be done, like ordering more tests or consults. [time-brightcove not-tgx=”true”] Patient portals have improved access to test results and physicians. Day or night, you can review yo...
Source: TIME: Health - March 19, 2024 Category: Consumer Health News Authors: Robert Glatter and Jesse Pines Tags: Uncategorized freelance Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on an information collection to support eligibility determinations for insurance affordability programs and enrollment through Health Benefits Exchanges, Medicaid, and CHIP Agencies. Comments are due by May 6, 2024. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - March 7, 2024 Category: Rural Health Source Type: news

Nursing Home Staffing Shortages and Other Problems Still Persist
Infection control lapses, severe staffing shortages and lowering vaccination rates have continued to plague many facilities beyond the pandemic. (Source: NYT Health)
Source: NYT Health - February 29, 2024 Category: Consumer Health News Authors: Andrew Jacobs Tags: Coronavirus (2019-nCoV) Nursing Homes Shortages Elder Care Labor and Jobs Inspectors General Protective Clothing and Gear Vaccination and Immunization Medicare Medicaid Centers for Medicare and Medicaid Services Health and Human Serv Source Type: news

Regulatory issues facing radiology groups in 2024
Sandy Coffta.Regulatory issues facing radiology groups in 2024 We pay a lot of attention to government regulation in healthcare, especially the Medicare Physician Fee Schedule (MPFS), which influences reimbursement not only from Medicare but also from other payers as many commercial contracts are tied to the MPFS. Although it is the object of most focus, the U.S. Centers for Medicare and Medicaid Services (CMS) is not the only agency that regulates healthcare. MPFS As of this writing, Medicare reimbursement for 2024 is nominally 3.4% lower across the board than it was in 2023 due to the statutory calculation that goes i...
Source: AuntMinnie.com Headlines - February 27, 2024 Category: Radiology Authors: Sandy Coffta Tags: Practice Management Source Type: news

Rural Maternal Health Series Webinars
Announces a 4-part webinar series, starting March 12, 2024, presented by the Federal Office of Rural Health Policy (FORHP) in collaboration with the Rural Health Information Hub, to support access to safe, high-quality maternity care in rural communities. Webinars will cover information on achieving the Birthing-Friendly Hospital Designation from the Center for Medicare and Medicaid Services (CMS), working with Perinatal Quality Collaboratives (PQCs) to improve care, implementing AIM bundles to improve patient safety, and how rural hospitals without birthing units can prepared for patient needs. (Source: News sto...
Source: News stories via the Rural Assistance Center - February 27, 2024 Category: Rural Health Source Type: news